HomeMy WebLinkAbout876359THE STATE OF WYOMING
ss
COUNTY OF
follows:
1. On the day of
876359 r r a CLERK
AFFIDAVIT OF SURVIVORSHIP
dE +S
KEMMET
ib0412 _PR PAGE
ANNIE MARSHINSKY, being first duly sworn upon her oath, deposes and states as
7-LJ my husband, GEORGE MARSHINSKY,
died, as is evidenced by the official certificate of death attached hereto and incorporated herein
by this reference.
2. At the time of his death my husband jointly held an interest in certain real property
with me, said real property being located in the County of Lincoln, State of Wyoming, and
more particularly described as follows:
Lot #44 of the Spring Canyon Ranches Subdivision the same as appears of
record on the official map of plat thereof filed in the Office of the County Clerk
and Ex- Officio Register of Deeds for Lincoln County, Wyoming
TOGETHER WITH all improvements, rights of way buildings, and all things
appertaining thereto.
3. Our interest in said real property was subject to an Agreement for Warranty Deed
dated June 4, 1987, and recorded in the Office of the Lincoln County Clerk and Ex- Officio
Register of Deeds on January 5, 1988, in Book 258PR at Page 271, wherein GEORGE
MARSHINSKY and ANNIE MARSHINSKY, husband and wife, were listed as purchasers.
4. By reason of my husband's death, I am entitled to sole interest, if any, in the above-
ON'Ai:;115,34
mentioned real property.
DATED this
WITNESS my hand and official seal.
My Commission Expires:
April 26, 2003
day of
2
2001.
ANNIE MARSHINSKY
SUBSCRIBED AND SWORN to and acknowledged before me this
July 2001, by ANNIE MARSHIT\TSKY
STATE OF
WYOMING
MY QOMMISSIN
Notary
blic
COUNTY OF
LINCOLN
Mthetitkitzkit
5
6th day of
01 4881
g1r k
4 J
This is a true and exact reproduction of the document on file in
the office of Vital Records Services, Cheyenne, Wyoming.
Date Issued: JUL 2 4 2001
W1?-r.47
g
Deputy State Re istt
This copy is not valid unless it bears a raised seal and is produced on
multicolored security paper.
un tgWnpn OF pF11TH T0. {gR,1VOFDEII^A
emorial ilospital`of.Sweetwater:County Rock',Springs .Sweetwater
9
.:TuNERAL 5,347270E IA:EN3EE 0.
lt1 OP?¢tRH 727 2477 92 07SA. 09no worry) D. fAARRE4 NEVER YATE4 77 SU1472LVR SPQU0E C/r watt. moo m. Wt.),
7YIO OIOE 4 ONJRC t Spmryl
Harried'
"AES/DSNOE STATE
,Anna ,Marie Stalliviere
12A:"USINL'CCUMTIONy6VA AM td m)# Gent awry OW 126 I7NDOFStrafic05 OR OPIUS7RY
7Y •ro lta fir. marl 1 3000!1
:Miner Re Cual Mining
1 30. CRY. MTh OR LOCATION 130. STREET AND WOOER
Lincoln Diamondvjlle
ANT •1UAs MTrr!Ad f. 1
Anne M rsh in sky
AD0R950 fir;° STREET ONSET) MASER
ost Office Box 33
106. DATE (Mn, Day. VT)
Feb. 16, 1994
14' 1AOS 0E0E0E10 OF 1175RM*C 03470707' 10. RACE- AnwGIn I7W M1
(Specify Mt na.UYaa, 0 t* '.1tMk: WNW. EIC
-GoOAR AWieo P3MO Rkel, Bo 'ISP.90Y)
.No �3 YoOO .White
A¢jclo flat 1B. 00TBER:9 NAME
210.NAME OF FAd1771
DUE TOMB AS A CONSEQUENCE ON:
DUE TO (OR A3 A CONSEQUENCE OF):
Number 01 AD0P.EBS OF FAGLRY
;154 .Elk S
Vase:Funeral.:Home 85 n: TVOmintt 829U.
uma Vbv r 'a. Y 0. 3 7 42 0 0 47 11 2 74 1 Intl, a
et 07e Woe. NU 0770 00420 and do to t q cH7e21l) W1o6 ao�Wpl��...
e3' (Ammo, mm TOW
210'fl1TE:S1@EO• 43 I11 1Y.).: 22*.HOUR OFC
e brear 16 1994 11 :3e
220.'.11AME OF ATTE770700 PIIT51CIA1t IF 0112ER THAN CERT4FIER (Typo b 37(7/)
AUr4.1, :161 Olals614o6a, or oo711CAIp7R 07/1 wool tle. i ter iro meW
7qi'; 0770 iAa1
amnia On,* m trsol'Ioloo,Ust oly ore m7ve77/ aa7A 747
WMED111T73 C(N5E IFln3T.:
td'NYha'R;C{id1(1
o:iilnc! oe.m» a Alzheimer's Dementia
Pa. NAME MO ATAIRESS,0F CERT7PIER (PHYSICIAN /M COROAER7Rroa or MO
John;:;C icheteau,,M.D.. 1208 Hilltop Drive, Rock S ^rings Wyoming R99m
CANT CONOIPONS•Conat. lnl sanIn,o m death 77 m/ mNte/ b Own wn M PART( I TT_ AUTOPSY (Smelly
t
AO
e0W0eoniosis. Pneumonia Yes
'MAM DEATH 700. DATE OF 0ON7Y 30a. TIME OF 000.11t1UN'1 AT 12DRKT 70d. DESCRIBE i1O1y
j i MUn0. Dr Y. V..) pUUt7Y eaVy. 3 5 tY m/
63A• r 3(7417 DF_ n*AlH,r_.a?�c'1
ale.. Februar
DATE OF.1o17i (10a.D.yy.:.2)
I6. DECEDENT'S EDLGO70N
•J 071,140w-6,1. e0?WIK0(4
E1rm d*T
ordso /SueoY 70.12, t?Ow 11 -4 0611..
10
b J
2ED. DATE RECEIVED EH REGISTRAR Ms. .DIY „7
February,l6, 1994